S’pore ranked last among 33 developed nations with 220k residents per hospital while S.Korea has 12.4k per hospital

Radar Healthcare, a UK company involved with safety in healthcare, published a survey in June this year to compare the healthcare systems of the 33 developed countries in the world.

Singapore was also included in the study.

Interestingly, it found that Singapore and Denmark have the lowest number of hospitals per 100 population ratio among the 33 first-world nations.

“We have Singapore and Denmark, which come in as the lowest-scoring countries for the number of hospitals vs population numbers, with 0.05% overall each,” Radar Healthcare said.

Radar Healthcare attributed Singapore’s low ratio to the very low amount of Singapore government’s spending on healthcare.

Indeed, according to data from the World Health Organization, Singapore pales in comparison with other first-world countries in terms of expenditure in the percentage of Gross Domestic Product (GDP).

South Korea, which was spending close to what Singapore was in 2000, ramped up its spending over 19 years and ended up spending 8.16 per cent of its GDP in 2019 while Singapore spent 4.08 per cent.

In the case of Denmark, it was due to the fact that the Danes focus on healthcare workers caring for patients in their homes rather than hospitals.

“The Danish Ministry of Finance wanted to focus on healthcare workers in patients’ homes rather than hospitals and that they were working on reducing the number of them to improve quality rather than quantity,” it added.

So, with 27 hospitals in Singapore, the ratio of population to hospitals is about 220,000 to 1.

The country that had the best number of hospitals compared to its population was South Korea, which has 4,133 hospitals to 51,329,899 people, or 12,400 people to 1 hospital.

“This left them with an overall percentage of 0.81%, highlighting that there are more than enough locations to treat sick people if needed,” Radar Healthcare said.

Japan came next with 15,100 population to 1 hospital. Radar Healthcare shared, “This is unsurprising, considering that Japanese citizens have a longer life expectancy compared to anybody else in the world, as their healthcare system is famous for focusing on preventative measures, rather than reactive ones.”

The third was Australia, with 19,500 population to 1 hospital. “The country focuses on a mix of private and public healthcare, which is a practice that is becoming more common across the globe – but it also relies on Medicare, which is a universal healthcare insurance scheme, paid for by the government and taxpayers,” commented Radar Healthcare.

The UK ranked 9th with 34,600 population to 1 hospital while the US ranked 13th with 54,500.

Severe Bed Crunch In Singapore

Recently, Straits Times reported that the bed crunch in public hospitals is so severe that it has spilled over to their emergency departments, many of which stay packed with patients because there is no room to move them elsewhere.

Emergency department (ED) doctors say there are days when the situation is so bad that an ambulance arriving is unable to discharge the patient for lack of space. Instead, the medical team has to assess the patients while they are on the ambulance trolley.

Minister of Health, Ong Ye Kung said in Parliament on Tuesday (8 Nov) that the bed crunch is about matching the demand and supply of hospital beds.

“The crowdedness and long waiting times for patients at the EDs in some hospitals, especially during a wave, is a manifestation of the problem of the mismatch of demand and supply of hospital beds,” said Mr Ong.

On the supply of hospitals in Singapore, Mr Ong gave three factors constraining the supply, and slowing down the process of warding ED patients.

1. A secular trend of rising number of patients with long stays, which reduces the turnover of hospital beds. To illustrate, the percentage of patients who stay longer than 21 days has doubled from 1.6% of all hospitalised patients in 2019, to 3.8% in 2022.
2. The pandemic caused construction disruptions which delayed the opening of healthcare facilities, namely the Woodlands Health Campus and the Integrated Care Hub at Tan Tock Seng Hospital. Construction delays due to the pandemic have also postponed the opening of several nursing homes and community day care facilities, and that also constrained the ability of hospitals to discharge less acute patients and free up hospital beds.
3. As part of Singapore’s emergency planning, hospitals are required now to set aside or ringfence beds for the care of COVID-19 patients.

If one were to look at the number of beds available in Singapore, one would notice that there is a sharp increase in beds made available from 2011.

This can be attributed to the mad rush to build new hospitals over the past couple of years such as Ng Teng Feng Hospital, Sengkang Hospital and Jurong Community Hospitals and others.

Based on the data, we can see that most were built after 2011 — The year when the People’s Action Party lost its first Group Representation  Constituency (GRC) in Aljunied at the General Election.

Note that the increase in hospital beds in 2013 was due to the opening of a private hospital and not a public one.

Historically, it may also be interesting to note that the total number of hospital beds (public & private) dropped from 11,936 in 2001 to 11,394 in 2011 (Dept. of Statistics) – whilst the number of hospital admissions increased from 384,054 to 469,445 – medical tourists increased to 850,000 a year.

While the government is continuing the construction of more hospitals, the comparison with other first-world countries, both in spending and supply of hospitals, would suggest the authorities are playing catch-up with the supply of hospital beds.